Treatment of benign paroxysmal positional vertigo. Transtympanic injection of local anesthetics (Lidocaine).:Transtympanic Injection of Local Anesthetics (Lidocaine)

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The authors treated 19 of 32 patients with symptoms of benign paroxysmal positional vertigo (BPPV) by transtympanic injections of a local anesthetic (Lidocaine). Eighteen of the patients experienced complete relief of the vertigo after seven or fewer transtympanic injections. 16 of them after only one or two injections. In patients with complete relief of vertigo after one injection, symptoms and postitioning nystagmus disappeared within 3 days. One of the 19 patients experienced a recurrence of BPPV after 3 months. The longer the clinical course, the more transtympanic injections were necessary. A characteristic nystagmus profile of BPPV was revealed by ENG recordings in the 9 patients in whom the affected side could be determined by other clinical findings. In 7 of the 9 patients, the horizontal fast phase components in the head-hanging position were toward the affected side and in the other 2 they were toward the contralateral side.